PC094 Increasing the Number of Integrated Vascular Surgery Residency Positions Is Necessary to Address the Impending Shortage of Vascular Surgeons in the United States

Abstract

The demand for vascular surgeons in the next two decades is expected to far exceed the current supply. While the number of fellowship programs is stable, the numbers of vascular residency programs and positions have expanded dramatically. We sought to evaluate the qualifications and characteristics of this new workforce in terms of its ability to meet the future needs. We conducted a retrospective review of national data compiled by the Association of American Medical Colleges (AAMC) and the National Resident Matching Program (NRMP) regarding integrated vascular residency programs (2008-2015) and fellowships (2007-2016). Variables included the number of applicants, sex, United States vs foreign medical school enrollment, applications per program, and applicants per position. Additionally, we conducted a retrospective review of applicants to the University of Massachusetts Medical School integrated vascular residency program from 2008 to 2015 to examine the aforementioned variables and United States Medical Licensing Examination Step 1 and Step 2CK scores over time. The number of integrated vascular residency positions increased from four in 2008 to 56 in 2015. Concurrently, the number of integrated vascular residency applicants grew from 112 in 2008 to 434 in 2015 (Fig 1). This increase has been predominately driven by a 575% increase in U.S. graduate applicants and a 170% increase in women applicants. The percentage of foreign medical graduates has decreased by 17% over the study period. The total number of applicants per residency position increased from 5.9 to 7.8. Meanwhile, the number of vascular surgery fellowship positions remained stable with an applicant-to-position ratio near 1:1 (Fig 2). At the University of Massachusetts Medical School, the mean United States Medical Licensing Examination Step 1 and Step 2CK scores among integrated residency applicants have improved annually, and consistently exceed the national average among U.S. applicants who have matched in their preferred specialty. Since the approval of a primary certificate in vascular surgery in 2005 and the subsequent rollout of integrated vascular residency programs in 2007, the number of residency programs and the quality of residency applicants has continued to increase. Demand from highly qualified medical school applicants vastly outweighs the current supply of training positions by eightfold. In contrast, demand from fellowship applicants matches the supply of fellowship positions. With a growing public health need for more vascular surgeons, these results suggest that additional residency positions would easily be filled with talented young surgeons.Fig 2Supply and demand for traditional vascular surgery fellowships (2007-2016).View Large Image Figure ViewerDownload Hi-res image Download (PPT)